Dextromethorphan Hydrobromide + Cetirizine HCL + Phenylephrine HCL + Menthol

SUSPENSION PRESENTATION:
Each 5 ml contains:
Dextromethorphan Hydrobromide IP         10 mg
Cetirizine Hydrochloride IP                         2.5 mg
Phenylephrine Hydrochloride IP                 5 mg
Menthol IP                                                 2.5 mg

Dextromethorphan Hbr. + Cetirizine HCL + Phenylephrine HCL + Menthol Suspension:
Dextromethorphan Hydrobromide is a cough suppressant which has a central action on the cough center in the medulla effective for the relief of non-productive dry cough.
Phenylephrine Hydrochloride is the most commonly used salt for the symptomatic relief of nasal congestion. It is intended for the relief of cough and cold symptoms.
Cetirizine hydrochloride is anti-histamine reported to be long acting and with some mast cell stabilizing activity. It is used for the symptomatic relief of hypersensitivity reactions including rhinitis.
Menthol exerts a cooling and local analgesic effect on the irritated and inflamed respiratory mucosa, thereby reduces mucosal irritation and generation of tussal impulses.

RATIONALE OF COMBINATION
Product Description:
The syrup consists of Cetirizine hydrochloride, Phenylephrine hydrochloride, Dextromethorphan hydrobromide and Menthol. It acts as a powerful vasoconstrictor. Cetirizine is used in allergic rhinitis and other allergic disorders. Cetirizine is a non selective anti-histamine. Dextromethorphan is a selective serotonin reuptake inhibitor and acts as an Anti-tussive agent and Phenylephrine is a nasal decongestant and also is used in the treatment of hypotension and shock as a cardiotonic agent during spinal anesthesia. Dextromethorphan is indicated to relieve coughs due to colds or influenza (flu).Dextromethorphan is a non-selective nasal decongestant and it produces longer duration of action.
It is an efficient cough remedy with active ingredients having powerful anti-tussive action for symptomatic relief of Dry Cough.

• Post Nasal Drip,
• Allergic & Vasomotor Rhinitis,
• Allergic Pharyngitis,
• Laryngitis & Sinusitis,
• Allergic cough following URTI and Surgery.

Dextromethorphan Hydrobromide is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor.
Absorption: Rapidly absorbed from the gastrointestinal tract.
Metabolism: Hepatic.
Half life: 3-6 hours.

Cetirizine HCL is potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects.
Absorption: Mean peak plasma concentration Cmax of 114 ng/mL at a time Tmax of 2.2 hours post dose was observed for cetirizine.
Protein binding: Very high (93%) plasma protein binding.
Half life: 8.3 hours.

Phenylephrine Hydrochloride is a sympathomimetic amine that acts predominantly on α-adrenergic receptors. In general, α1-adrenergic receptors mediate contraction and hypertrophic growth of smooth muscle cells.
Absorption:Completely absorbed after oral administration. Peak serum concentrations are achieved approximately 0.75-2 hours following oral administration.
Protein binding 95% binding-plasma proteins.
Metabolism: Undergoes extensive first-pass metabolism in the intestinal wall and extensive metabolism in the liver.
Route of elimination: PPhenylephrine and its metabolites are mainly excreted in urine.
Half life: 2.1 to 3.4 hours.

Menthol is a covalent organic compound made synthetically or obtained from peppermint or other mint oils. Menthol\'s ability to chemically trigger cold-sensitive receptors in the skin is responsible for the well known cooling sensation that it provokes when inhalated, eaten, or applied to the skin. It should be noted that menthol does not cause an actual drop in temperature.

Narcotics and sleep medications are known to interact with the components of the syrup. Consult with your physician before use.

• Drowsiness
• Dizziness
• Dry mouth
• Nervousness

Hypersensivity reactions to any of the components of the syrup.

• Caution should be taken in pregnancy and nursing mothers. Small amounts of phenylephrine are secreted in breast milk. Use only when benefits outweigh risks in this class of patients.
• Use only as prescribed.
• Do not take any medicine after the expiry date.